Provider Demographics
NPI:1578501839
Name:SMITH, STEVEN HENRY (LPCC-S, LICDC-CS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HENRY
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPCC-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CAVALIER BLVD STE 313
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5172
Mailing Address - Country:US
Mailing Address - Phone:513-372-5923
Mailing Address - Fax:
Practice Address - Street 1:71 CAVALIER BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5121
Practice Address - Country:US
Practice Address - Phone:513-372-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121053101YA0400X
OHE.1700098101YM0800X
KY279929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100860090Medicaid
KY184607OtherMEDICARE GROUP NUMBER